John Mason, Ph.D.,1 Professor, Department of International Health and Development

School of Public Health and Tropical Medicine, Tulane University

Nutrition Surveillance: Making Decisions to Improve and Protect Nutrition

Nutrition surveillance means to watch over and make decisions that will lead to improvements in the nutrition of populations (FAO/WHO/UNICEF, 1976). Nutrition information—when appropriately linked to interventions, policies, and programs—can help mitigate malnutrition, particularly in developing countries (Figure 5-1). The current economic and food crises serve as stimuli for the world to be concerned about nutrition and perhaps can foster movement in the direction of positive change for nutrition surveillance.

In public health, the “surveillance cycle” is well established and understood. One starts at the point of collecting data, the analysis leads to decisions on action, the action is implemented, the situation is followed, and new data can be used to monitor and evaluate that situation at the same time as detecting new problems (Figure 3-1). This surveillance process applies in the area of nutrition, usually at the population level but may also refer to individuals or households.

Do We Really Know How Many People Are Hungry? (And What Does That Mean?)

The official Food and Agriculture Organization of the United Nations (FAO) estimates from 2009 show that the number of the world’s “hungry” has hit 1 billion (Food and Agriculture Organization of the United Nations, 2009). This estimated increase in the world’s hungry is similar to that seen around the year 1970, at the time of another world food crisis. Yet hunger is a very “lazy” indicator; its meaning is not very clear and not often explained, and its method of calculation is suitable only to inform that the hunger situation is getting worse.

The true definition of this “hungry” indicator is the number of people who during the course of the past year did not on average get enough food energy to maintain moderate activity and body weight (UN ACC-SCN, 1993). The calculation of this indicator takes the estimated calorie availability at a national level (dietary energy supply [DES]) and sets that together with an estimate of the coefficient of variation (CV) of the distribution of consumption and estimates the number below a certain cut point. It does not take into account a number of


The following people contributed to Dr. Mason’s presentation: Megan Deitchler, M.P.H., FANTA; Marito Garcia, Ph.D., The World Bank; A. Sunil Rajkumar, Ph.D., The World Bank; and Roger Pearson, M.A., UNICEF.

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